Aging in Place

I’m recycling an idea I learned about a decade ago. And happily writing about it again, as this is a great idea and it is finally taking root in Texas, and several other places, after germinating in Boston. Beacon Hill Village was the first of its kind, a virtual as well as a physical village, or community, re-thought and repositioned in 2002 to support neighborhood residents aging in place.

Aging in place means not having to move out of your home and into a “home” — or a retirement community, senior residence, or assisted living or worse. It means not institutionalizing old age but building into one’s home and neighborhood the services and personnel that can keep elders safe and actively engaged in the life they’ve made there. Aging in place even promises, according to its advocates, to stave off the need for full-time elder care for ten (10!) years.

What a Village demands along with respect for our independence is an awareness of our interdependence at different times in our lives, and especially as we age. It requires a willingness to look to each other and the community we comprise to meet our needs at this stage of life — the need for social interaction, civic and cultural activities, accessible health care, transportation, assistance, sometimes, with the tasks of daily living such as shopping, cooking and home maintenance, and even, organizers in Dallas say, for a walk in the park and a bench to sit on when you get there.

The Beacon Hill Village founders initially published a how-to guide to help other communities adapt the program to their own particular geographies and cultures, and then joined with Capital Impact Partners, a nonprofit community development financial institution to create Villages-to-Villages (VtV) and the VtV Network to even more actively support the development of new Villages. The VtV Network currently includes 150 registered Villages in the U.S., Australia and the Netherlands, and has 120 additional Villages in formation, including one in Dallas.

The women spearheading the Dallas project, volunteers Renee Karp and Caren Edelstein, have identified the Preston Hollow neighborhood where they’ll begin and are in the process of filing for nonprofit 501(c)(3) status. They’ve been talking to a variety of people and organizations they think should be interested in the project as service providers or funding sources, with mixed results. Among those consulted — and I list them to show the many ways services and perspectives can be — must be — integrated to make a Village work — are: Community Council of Greater Dallas, VNA, Senior Source, Shared Housing Center, Dallas Co-Housing, foundations, real estate associations, pharmaceutical companies, Dallas City Parks and Recreation, churches and synagogues, hospitals, health care and home health organizations, local universities, campus volunteer organizations, and the Volunteer Center of Dallas. They’ve received coaching from the Nonprofit Finance Fund of the Rockefeller Foundation, and they’ve studied VtV Network guidelines and Villages established in Portland, Maine and Austin and Galveston, Texas. They know that it not only “takes a Village,” it takes staff, volunteers and strategic partnerships once the aging residents (starting at age 50 or 55, most often 65) have identified and prioritized their specific needs.

In the target neighborhood, it turns out, 46 percent of the population is over 65. Yet most of the residents don’t know that because they don’t know each other despite living in an area a mile wide and four blocks high. They don’t realize the potential market power they can exercise to increase their access to services, both volunteer and professional and to group discounts. Because they don’t know each other, they haven’t shared information about the challenges they have in common — health, safety, understanding technology, transportation after dark, staying engaged in civic, social and cultural activities, the loss of friends, increasing isolation, conflict with families about living alone, and all the mundane physical and emotional vicissitudes of aging. Nor have they shared information about potential solutions. They find the several senior lifestyle and housing options they’ve considered or examined too expensive, too confining, too depressing, too much moving somewhere to die. And until recently, they didn’t even imagine there was a possible solution right in their own back yard.

According to Karp and Edelstein, Village fees (which run from $500 to $1000 a year based on whether the member is an individual or a couple and where the Village is located) generally cover 60 percent of the operating expenses; the rest has to be raised from foundations and other donor enterprises, in large part to increase access to populations that might not otherwise be able to afford to participate. The motivation for donors? Aging in place — safely — is far less expensive than the emergency room care, hospital stays, and nursing homes Society must underwrite, via Medicare, for example. And far more efficient for delivering the services increasing numbers of aging citizens are going to be demanding from their cities, services such as home health care, wellness visits, exercise classes, home repairs or renovations to reduce the risk of falls, transportation to plays and concerts and movies and parks, things that keep aging resident contributing to the economy and, even more importantly, the fabric of life in a community.

How this works depends on the specific community and the Village membership. Generally a Village hires an executive director who, with the Village’s volunteer leadership, creates an electronic Village network for the membership, develops strategic partnerships with service providers — health care professionals, yoga teachers, universities, safety monitors, taxi, limousine or bus services, city agencies, home repair businesses — and coordinates volunteers who can help with the residents by socializing, driving, shopping and walking, for example, with them. The Beacon Hill Village website explains it this way: “The Village cares about the whole person as it responds to individual interests and requests. We offer a great variety of activities and social events. We take pride in offering members a solution or helpful response whenever they call the Village office.” The Village office, then, becomes a kind of Concierge for the residents — for $500 to $1000 a year (N.B., Not a month)!

As I talked with Karp and Edelstein, I was reminded of my homeowner/neighborhood association and the NextDoor electronic communications I’ve been receiving this past year as a dues-paying member. Our association has begun screening or commenting on service providers (plumbers, electricians, contractors) and promoting off-duty police patrols for safety, and it recently created the opportunity for families with young children to find each other in the neighborhood. Seems to me we could do the same thing, just in the neighborhood, to enhance the prospect of aging in place here, too. After all, it takes a Village.